Does Botox effects on tear trough?

Hello, I've been Receiving Botox on crows feet & frown lines for less than a year. I'm 28 and doing it for preventative measures. Recently I've noticed some progressive hollowing of my tear trough area. Could Botox could be the cause of this?

Doctor Answers 14

Tear Troughs and #Botox: Lateral Relaxation of the Orbicularis (Crow's Feet)

Botox is great for the Crow's Feet area. The muscle targeted with crow's feet injection is the lateral orbicularis oculi muscle which does indirectly contribute to tear troughs in the inner eye aspect. Relaxation of this muscle may reveal more shadowing in this area contributing to a perceived deeper tear trough. This may be a stretch, and tear troughs in general are worsened with the aging cheek, though 28 is not too early for familial peri-orbital  aging. For tear troughs try a volumetric filler, active skin care and a light chemical peel. These are all methods of treatment which are in-office which can effectively treat this area. If you are getting Botox, work on the other areas too.


Austin Plastic Surgeon
4.9 out of 5 stars 28 reviews

Botox and tear trough deformity

First off, I am not a fan of Botox as a "preventative treatment" for wrinkles, as I have not seen any scientific data supporting this notion. Botox treatment around your eyes for crows feet, could theoretically, make tear troughs more prominent. Botox is not recommended to treat tear troughs. Try stopping your preventive treatment and see what happens, and seek a second opinion from a board certified plastic surgeon or dermatologist 

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews

Effect of Botox on Tear Trough

Hi MMZZ,


There is some possibility that tear trough may appear in the younger age group as well and we have seen cases of the appearance of tear trough related to botox injection depending on the technique of the doctor. If botox is injected around the lower lid, relaxation of the muscle on the area may cause prominence of he fat flap on the area or thinning of the muscle which finally results to the appearance of tear trough.

Somyos Kunachak, MD
Thailand Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Botox and lower eyelids

Botox works quite well for preventative measures of frown lines.

To prevent crow's feet from forming, Botox is not a bad strategy. Plus, the effects are quite nice.

The best prevention for crow's feet is avoiding the sun and cigarette smoking.

When injecting crow's feet, if the injections are given towards the medial side (towards the nose) or inside from the corner of the eye, some weakness of the muscle can cause the lower eyelid fat pads to protrude.

This may look like a deepening of the tear trough.

Consider having your injection pattern changed a little bit for your next treatment to see if this helps.

Best of luck,

Mats Hagstrom, M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 17 reviews

Botox and tear trough

I have never heard or read about botox affecting the tear trough so I think whatever is going on is independent of the botox. Botox works by inhibiting neuro-muscular transmissions and most people dont have and significnat muscle tissue in the tear trough so anatomically this would not make sense

Marc S. Zimbler, MD, FACS
New York Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox effect on tear trough

The hollowing of the under eye area is an age- related change which occurs as a result of loosening of the ligaments holding the globe of the eye in place, causing the globe to move slightly backward and creating a hollow/empty space below the eye on the bone. Botox Cosmetic® has no effect on this process, however the dermal fillers Restylane® and Belotero® work very well in filling this space and eliminating these hollows. Even better, their results can last up to one year or more!

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 8 reviews

Botox generally not recommended to treat the tear trough area.

Botox is not likely to improve the appearance of the tear trough area. In fact, it's possible that Botox injection to this area could worsen the appearance of the tear trough and may lead to other complications. Filler injections, such as Restylane, would be a better options. Your best bet is to consult with a board-certified specialist (Facial plastic surgeon, plastic surgeon, or dermatologist) who is highly experienced with facial filler injections.Good luck!
Dr. Harmych 

Brian Harmych, MD
Cleveland Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Can Botox worsen the tear trough?

Properly injected Botox will not affect the tear trough area in any way. If you've noticed worsening tear troughs this is likely due to aging and volume loss. This can be pronounced at an even a young age in people who are thin. I can only assume that you do not have much body fat. The best remedies for deep tear troughs at the present time are dermal fillers such as Belotero or fat transfer. Best.

Tear troughs are improved with filler, not Botox

The best way to improve the tear troughs is with dermal filler.  My favorites are Restylane and Sculptra.  I use cannulas for this area because it is safer and there is less downtime.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Tear trough after botox?

Hello,
Botulinum toxin works by paralizing the muscle that is causing wrinkles.  I have had patients that complain of having a more prominent line on the lower eyelid after receiving injections for crow's feet.  Tear troughs develop due to the aging process as the fatty pocket begins to pseudoherniate forward.  This can easily be fixed with restylane.  I would consult a physician with experience injecting restylane in the periocular region.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.